Work-related psychosocial risk factors and psychiatric disorders: A cross-sectional study in the French working population

Astrid M. Chevance; Oumou S. Daouda; Alexandre Salvador; Patrick Légeron; Yannick Morvan; Gilbert Saporta; Mounia N. Hocine; Raphaël Gaillard

doi:10.1371/journal.pone.0233472

Peer Review History

Original SubmissionFebruary 11, 2020
23 Apr 2020 Decision Letter - Raoul Belzeaux, Editor PONE-D-20-02569 Work-related psychosocial risk factors and prevalence of psychiatric disorders: A cross-sectional study in the French working population. PLOS ONE Dear Dr. Chevance, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. We would appreciate receiving your revised manuscript by Jun 07 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. 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Please note that supplementary tables (should remain/ be uploaded) as separate "supporting information" files 3. Thank you for stating the following in the Competing Interests section: "“None”: Oumou Daouda, Mounia N. Hocine, Yannick Morvan and Alexandre Salvador report no conflict of interest Astrid Chevance received a PhD grant from La Fondation pour la Recherche Médicale (FMD20170637634) Raphaël Gaillard has been a member of a scientific board for Janssen, Lundbeck, Roche, SOBI and Takeda. He has been a consultant or speaker for Astra Zeneca, Boehringer-Ingelheim, Pierre Fabre, Lilly, LVMH, Lundbeck, MAPREG, Otsuka, Pileje, Sanofi, Servier and has received professional fees and has received funding for research from Servier. He is a founding member of Regstem. He is the president of the Fondation Pierre Deniker. Gilbert Saporta is currently a consultant for Ipsos. Patrick Légeron is a founding member of Stimulus." 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We will update your Data Availability statement on your behalf to reflect the information you provide. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This is a very interesting manuscript, very well written, and bringing original evidence. This is indeed the first epidemiological French study made on a representative sample of the working population. Representativeness was achieved by using quota sampling. The methodology is very sound and follows international standards. The authors conducted a STROBE-compliant cross-sectional study of a representative sample of the French workers, allowing to estimate the prevalence of probable psychiatric disorders in this population and among workers exposed to work-related psychosocial risk factors. I have few comments: - It is surprising to include individuals aged 18 to 80 years, in a study on active workers in a country where the age of retirement is around 60 to 62 years old. Moreover, the study excluded retired people. Nearly 5% of the study sample is aged more than 60. Can you clarify this point please ? - In this study, 42.6% of participants had a work duration of more than 39h a week, while the legal work duration is 35h a week. Who's is concerned by this ? Workers, independent, managers ? - One major result is that the imbalance of work and personal life embodied the most strongest association with psychiatric disorder. This is a clearly very relevant result even from clinical point of view, as it is frequently observed in workers suffering from burnout. Reviewer #2: This is a very interesting study about the estimation of the prevalence of probable psychiatric disorders in the working population, and the assessment of the proportion of people presenting a probable psychiatric disorder among people exposed to work-related psychosocial risk factors. A strength of the study is that it is conducted in a large sample representative of the French population. Only few points should be clarified. First, authors should define patients exposed vs unexposed regarding the psychosocial risk factors (PSRF). I think that a patient who is exposed to one PSRF given is a patient with a score of 1 regarding this PSRF in the list of 44 questions. But, authors should write it clearly. Second, I do not understand well this sentence: “These two PSRFs were the most reported, with 75.7% and 70.5% of the sample reporting having a job that required constantly adapting to new things and 70.5% reporting often being in contact with customers/clients/users.” This sentence should be re written. Except these two points, this manuscript is very clear with a consistent statistical analysis. Moreover, results are very interesting. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. 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Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0233472.r001
Revision 1
1 May 2020 Author Response Responses to the reviewers: We thank all reviewers for their careful reading. Their comments greatly helped us improve our work. Please find in blue our comments and in green the modification of the manuscript. Reviewer #1: This is a very interesting manuscript, very well written, and bringing original evidence. This is indeed the first epidemiological French study made on a representative sample of the working population. Representativeness was achieved by using quota sampling. The methodology is very sound and follows international standards. The authors conducted a STROBE-compliant cross-sectional study of a representative sample of the French workers, allowing to estimate the prevalence of probable psychiatric disorders in this population and among workers exposed to work-related psychosocial risk factors. We thank Reviewer 1 for the positive comments and encouragements. I have few comments: - It is surprising to include individuals aged 18 to 80 years, in a study on active workers in a country where the age of retirement is around 60 to 62 years old. Moreover, the study excluded retired people. Nearly 5% of the study sample is aged more than 60. Can you clarify this point please ? The eligibility criteria were: - Individuals aged 18 to 80 years AND - Having a job (e.g. any kind of job, including part-time/self-employment) Exclusion criteria: - Students - Unemployed individuals - Housewives/husband - Retired people A report of the French National Institute for Statistical and Economical Studies from 2018, showed that 5% of people aged [65-74] have an occupation (mainly men, with a good health condition, high education and living in the Parisian area). Top managers but also self-employed and farmers are overrepresented. Four profiles are described: employees with low education with part-time job, people with high education living in big cities, shopkeepers and farmers. (https://www.insee.fr/fr/statistiques/3646000?sommaire=3646226). To collect data on the senior workers, we included people over the legal retirement age, who declared an occupation. They represented 4.5% of our whole sample (see supplementary table 2 page 3) which is consistent with the national statistics. - In this study, 42.6% of participants had a work duration of more than 39h a week, while the legal work duration is 35h a week. Who's is concerned by this ? Workers, independent, managers ? We performed supplementary statistics on this population of workers who reported working more than 39h per week in the table hereunder. Our results are consistent with the report of the French National Institute for Statistical and Economical Studies from 2017 with a mean work duration of 50.5 hours a week for self-employed and 39.1 hours a week for employees. (Please see figure 5 in https://www.insee.fr/fr/statistiques/3676634?sommaire=3696937) Work duration ≥ 39 hours / week (n=1423) Work duration < 39 hours / week (n=1777) Sex Male 62.9 42.9 Female 37.1 57.1 Age, years 42.0 (10.7) 40.9 (11.4) Number of children None 50.1 54.5 1 23.4 20.5 2 21.2 18.9 3 4.6 4.9 > 4 0.6 1.2 Highest educational degree baccalaureate degree 18.2 23.6 Baccalaureate degree 19.2 23.5 Baccalaureate degree +2 years 24.6 23.9 Baccalaureate degree ≥ 3 years 38.0 28.9 Annual household income (euros) < 15 000 7.8 13.7 15–24 000 17.4 22.8 24–36 000 25.1 27.0 > 36 000 37.7 23.0 No information 11.9 13.5 Occupational status Independent worker 16.2 7.4 Employees 83.8 92.6 Size of company (no. of employees) < 10 21.6 22.3 10–49 20.0 24.5 50–99 9.7 11.2 100–499 19.3 21.3 > 499 17.1 16.0 No information 12.3 4.7 Activity sector Industry 11.1 14.0 Building 15.2 8.3 Trading 12.1 11.7 Transport 5.5 5.6 Insurance and real estate 3.6 3.2 Education, health and social work 19.5 26.4 Other services 33.1 30.9 Duration of job < 6 months 3.7 7.0 6 months–5 years 33.2 33.9 6–10 years 21.6 21.8 > 10 years 41.5 37.3 Commuting duration < 30 min 55.6 61.6 30 min–1hr 21.4 22.2 > 1hr 23.0 16.2 - One major result is that the imbalance of work and personal life embodied the most strongest association with psychiatric disorder. This is a clearly very relevant result even from clinical point of view, as it is frequently observed in workers suffering from burnout. We agree with the reviewer that the imbalance of work and personal life is a major result of the study that echoed clinical practice. In this study we choose to focus on mental disorders and not on burn-out which is not part of the current mental disorder classification (neither the DSM-5 nor the ICM-10), as mentioned in the discussion. ********************** Reviewer #2: This is a very interesting study about the estimation of the prevalence of probable psychiatric disorders in the working population, and the assessment of the proportion of people presenting a probable psychiatric disorder among people exposed to work-related psychosocial risk factors. A strength of the study is that it is conducted in a large sample representative of the French population. Only few points should be clarified. We thank the reviewer for acknowledging our work with positive comments. First, authors should define patients exposed vs unexposed regarding the psychosocial risk factors (PSRF). I think that a patient who is exposed to one PSRF given is a patient with a score of 1 regarding this PSRF in the list of 44 questions. But, authors should write it clearly. We add a sentence in the method section (paragraph 2) Measurement of psychosocial risk factors PSRF): “Therefore, participants with a score of 1 to a given PSRF are called “participants exposed” to this PSRF in the results section.” Second, I do not understand well this sentence: “These two PSRFs were the most reported, with 75.7% and 70.5% of the sample reporting having a job that required constantly adapting to new things and 70.5% reporting often being in contact with customers/clients/users.” This sentence should be re written. We corrected the sentence as followed (results section, “exposure to work-related PSRFs): “These two PSRFs were the most reported, with 75.7% of the sample reporting having a job that required constantly adapting to new things and 70.5% reporting often being in contact with customers/clients/users. “ Except these two points, this manuscript is very clear with a consistent statistical analysis. Moreover, results are very interesting. Response to the editor: - We formated the manuscript according to Plos One standard. - We decided to make the the data set available (open access) as supporting information. - We add the specific sentence to the conflict of interest statement. Attachments Attachment Submitted filename: Response to reviewers.docx https://doi.org/10.1371/journal.pone.0233472.r002
6 May 2020 Decision Letter - Raoul Belzeaux, Editor Work-related psychosocial risk factors and psychiatric disorders: A cross-sectional study in the French working population. PONE-D-20-02569R1 Dear Dr. Chevance, We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements. Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication. Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. With kind regards, Raoul Belzeaux, M.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0233472.r003
Formally Accepted
12 May 2020 Acceptance Letter - Raoul Belzeaux, Editor PONE-D-20-02569R1 Work-related psychosocial risk factors and psychiatric disorders: A cross-sectional study in the French working population. Dear Dr. Chevance: I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. For any other questions or concerns, please email plosone@plos.org. Thank you for submitting your work to PLOS ONE. With kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Raoul Belzeaux Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0233472.r004

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